BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 970|
|Office of Senate Floor Analyses | |
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THIRD READING
Bill No: SB 970
Author: De León (D), et al.
Amended: 5/29/12
Vote: 21
SENATE HEALTH COMMITTEE : 8-0, 4/11/12
AYES: Hernandez, Harman, Alquist, Anderson, De León,
DeSaulnier, Rubio, Wolk
NO VOTE RECORDED: Blakeslee
SENATE APPROPRIATIONS COMMITTEE : 5-2, 5/24/12
AYES: Kehoe, Alquist, Lieu, Price, Steinberg
NOES: Walters, Dutton
SUBJECT : Health Care Reform Eligibility, Enrollment, and
Retention
Planning Act: coordination with other programs
SOURCE : Western Center on Law and Poverty
DIGEST : This bill requires the states new single
application for health subsidy programs (being developed
pursuant to the Affordable Care Act) to interface with
eligibility and enrollment systems used by county social
service programs.
ANALYSIS :
Existing law:
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1. Requires the California Health Benefit Exchange
(Exchange) to inform individuals of eligibility
requirements for the Medi-Cal program, the Healthy
Families Program, or any applicable state or local
public program. Requires, through screening of the
application for coverage by the Exchange, if the
Exchange determines that an individual is eligible for
any such program, the Exchange to enroll that individual
in the program.
2. Requires, under the Health Care Reform Eligibility,
Enrollment, and Retention Planning Act, the California
Health and Human Services Agency (Agency), in
consultation with the Department of Health Care Services
(DHCS), the Managed Risk Medical Insurance Board
(MRMIB), the Exchange, the California Office of Systems
Integration, counties, health plans, consumer advocates,
and other stakeholders to undertake a planning and
development process regarding the federal Patient
Protection and Affordable Care Act (ACA) related to
eligibility for, and enrollment and retention in, state
health subsidy programs.
3. Requires DHCS, in consultation with MRMIB and the
Exchange, to develop a single, accessible, standardized
paper, electronic, and telephone application for state
health subsidy programs as part of the stakeholder
process in #2 above. Requires the application to be
used by all entities authorized to make an eligibility
determination for any of the state health subsidy
programs, and by their agents.
This bill:
1. Requires, at the time of initial application for or
renewal of health care coverage using the single state
application required under existing law, that an
individual be allowed to consent to have his or her
application information used by the appropriate county
human services department to initiate a simultaneous
application for CalWORKs and CalFresh, and by other
state or local departments for other human services or
work support programs identified by the workgroup
established by this bill.
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2. Requires a county human services department, with a
beneficiary's consent, to take information used to renew
a beneficiary's eligibility for a state health subsidy
program and use that information to continue or
recertify CalWORKs or CalFresh benefits for all eligible
individuals, if the information is sufficient to meet
the requirements for a CalWORKs or CalFresh semiannual
report or annual recertification.
3. Requires Agency to convene a workgroup of human services
and health care advocates, legislative staff,
representatives of county human services departments and
county eligibility workers, and staff from appropriate
state and local departments, to consider and develop a
plan for the integration of additional human services
and work support programs into the process described in
#1) above.
4. Requires the above requirements to be implemented by
December 31, 2015.
5. Requires DHCS, in conjunction with counties, the
Department of Social Services, and representatives of
the Statewide Automated Welfare System (SAWS) consortia,
county eligibility workers, consumers, and other
affected stakeholder groups, to conduct a planning
process and develop administrative enrollment and
renewal policies and procedures, which DHCS is required
to implement by means of all-county letters or similar
instructions from the director.
Background
The ACA, enrollment application process, and this bill
proposes changes. The ACA makes numerous changes to
increase the number of individuals with health coverage.
These changes include requiring a single streamlined form
for state health subsidy programs, and by allowing
individuals to be able to apply in person, by mail, through
the internet, or by telephone.
California, through the Exchange, has issued a request for
proposal (RFP) to implement a new information technology
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system known as CalHEERS (California Healthcare
Eligibility, Enrollment and Retention System). CalHEERS
will provide a "one-stop-shop" to determine eligibility for
non-subsidized health coverage for individuals in the
Exchange, and subsidized coverage for individuals eligible
for state health subsidy programs. The Exchange RFP for
CalHEERS calls for vendors to provide the ability to notify
the applicant that he or she may be eligible for other
state programs (for example, CalWORKs and CalFresh), that
would direct the individual to the appropriate links, and
collect and send the basic application data (along with any
documents provided by the applicant) to the system of
record for that program to complete the application
process. The Exchange asked vendors to have the ability to
provide this expanded system by December 31, 2015, but the
Exchange has a not made a decision on whether it wishes to
purchase these additional services (known as a "state
option to buy"). Vendor submissions to the Exchange were
submitted earlier this year, and the bids are not public
information. Vendor selection is anticipated for late
April or early May 2012. Once the contract has been
awarded, the contract and the dollar amounts will be made
public.
The current application process for Medi-Cal is primarily
through county human services departments, where
individuals can apply either in person, through the mail,
or online. In addition, individuals can also apply
(through the county) for enrollment in human services
programs such as CalWORKs or CalFresh (previously known as
Food Stamps) using the same application, but those programs
have additional requirements that Medi-Cal does not.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee, unknown
costs to convene a workgroup and develop a plan to
integrate social service program eligibility and enrollment
systems into the single application (mostly federal funds).
SUPPORT : (Verified 5/29/12)
Western Center on Law and Poverty (source)
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ACCESS Women's Health Justice
Alameda County Community Food Bank
American Federation of State, County and Municipal
Employees, AFL-CIO
California Association of Food Banks
California Black Health Network
California Catholic Conference, Inc.
California Children's Health Coverage Coalition
California Commission on Aging
California Communities United Institute
California Coverage & Health Initiatives
California Family Resource Association
California Food Policy Advocates
California Hunger Action Coalition
California Pan Ethnic Health Network
California Partnership to End Domestic Violence
California Rural Legal Assistance Foundation
California School Nutrition Association
California WIC Association
Catholic Charities of California United
Children Now
Children's Defense Fund
Coalition of California Welfare Rights Organizations, Inc.
Community Clinic Association of Los Angeles County
Consumer Federation of California
County Welfare Directors Association of California
George M. Shirakawa, President, Santa Clara County Board of
Supervisors
Greenlining Institute
Having Our Say
Health Access California
Hunger Action Los Angeles
Jericho: A Voice for Justice
La Cooperativa Campesina de California
Latino Coalition for a Healthy California
LifeLong Medical Care
Los Angeles Regional Food Bank
Madera Coalition for Community Justice
National Association of Social Workers
National Health Law Program
River City Food Bank
San Francisco Food Security Task Force
Service Employees International Union
The Children's Partnership
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United Way CA
ARGUMENTS IN SUPPORT : According to the author's office,
this bill has two goals: (1) to allow consumers applying
for health coverage through the new streamlined California
Healthcare Eligibility, Enrollment and Retention System
(CalHEERS is an information technology system) to also
apply for human services programs, so they can receive
needed public benefits; and (2) to maximize enrollment in
health coverage by 2014 by identifying CalFresh recipients
who are uninsured and, with their consent, using their
CalFresh information to apply for health coverage.
Integrating human services programs into CalHEERS increases
administrative efficiency and streamlines the application
and renewal processes for consumers. The benefits of
maximizing health coverage enrollment are several.
Californians will be required by law to have health
coverage in 2014 and coverage for the newly eligible will
be paid for with 100 percent federal funds from 2014-2016,
going to a still-high 90 percent federal match by 2020.
Multiple strategies are needed to maximize health coverage
enrollment including "pre-enrollment" of eligible
populations such as CalFresh recipients. Additional
strategies to reach those eligible for CalFresh benefits (a
100 percent federally financed benefit) are also needed
given California's low participation level.
CTW:do 5/29/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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